CLINICAL AND ETHICAL ISSUES
PSY7505/7506
Fall and Spring Semesters 2009-2010
Course Information Packet
Term and Year: Fall, 2009 & Spring, 2010
Class location: One Beach Street, San Francisco
Class Meeting days and time(s): Friday, 10:00-11:50
Instructor Name and Title: Kathy Trost, Ph.D. Adjunct and Liaison Faculty
Office location: SF Campus, TBD
Email address: kathytrost@aol.com
Phone: 925-284-4777
Office Hours: By appointment
Grading: Letter grade
Credit hours: 2 credits per semester

I. Course Rationale:

The PsyD and Ph.D. clinical psychology programs are organized to enable students to build sequentially on knowledge and skills. This course is part of the PsyD/PhD shared curriculum. Each practicum experience is complimented by a didactic course for the purposes of accomplishing this integration. The second year Clinical and Ethical Issues Seminar course is the didactic course that accompanies the G-2 practicum experience. In this course students consolidate G-1 level clinical competencies and master G-2 level clinical competencies. Students draw upon skills and knowledge obtained in the first year of the program and continue to develop and build upon them.

The second year Clinical and Ethical Issues Seminar course is the didactic course that accompanies the G-2 practicum experience. This course is part of the PsyD/PhD shared curriculum. Each practicum experience is complimented by a didactic course for the prupose of integrating conceptual knowledge with the application of theory/concepts in the practicum seting. Each course in the PsyD and PhD program is designed to accomplish program specific learning outcomes (or training goals and objectives). This course is related to the outcome of developing graduates who use ethical principles as a guide for professional practice and self-evaluation as a basis for professional growth.

Ethical knowledge, commitment, and integrity, and an understanding of legal rules governing the practice of psychology are fundamental to the formation of competent, effective psychologists. This course is a core course in providing this necessary knowledge and understanding, and in providing essential information required to meet ethical standards articulated by the APA, and by other governing organizations and institutions. More specifically, this course addresses the learning outcome of becoming familiar with written case presentation methods, ethical issues, and legal issues related to the practice of psychology and psychotherapy with children, adults and families.


II. Course Description, Purpose, Student Learning Outcomes and Assessment:

A. Course Description
Taken concurrently with Field Practicum I by second-year clinical Ph.D. students and with Field Practicum II by clinical Psy.D. students, this seminar provides a small group forum for field placement advising, discussion of agency issues and preparation of clinical case materials. Particular emphasis is placed on developing competency in history taking and initial interviewing, case formulation and treatment planning, and understanding the dynamics of the therapeutic relationship as a context for case formulation and treatment intervention. In addition, ethical and professional issues are examined in the context of fieldwork.

B. Purpose of the Course
The purpose of this course is to give an overview of ethical and legal issues in the context of clinical practice. Thus, in addition to developing skills in case presentation and formulation, students will develop knowledge of the ethical and legal context within which they will practice. In this regard, students will obtain specific knowledge regarding psychotherapy with adults, children, adolescents and families. Students also will focus on the clinical and ethical dimensions of their current placement experiences and learn to develop a structured oral and written case presentation. An additional purpose is to help students develop their skills in case consultation by providing professional input to their colleagues.

C. Specific Learning Outcomes:
Upon successful completion of the course, students will be able to:
1. Gather and synthesize clinical information from clients and other sources to develop diagnostic (DSM) and clinical impressions.
2. Present clinical cases (oral and in writing) in a comprehensive and professional manner, using a standard structure and format, which includes patient history, diagnosis, and case formulation.
3. Consider psychological concepts, especially the context for, and meaning of, behavior.
4. Begin to apply psychological concepts in clinical interventions.
5. Begin to Incorporate theoretical perspectives and concepts into case presentations (2nd semester).
6. Identify situations and issues requiring ethical decision making.
7. Increase understanding of ethical duties as a developing psychologist.
8. Identify legal issues relevant to professional practice.
9. Apply legal and ethical principles to develop an appropriate course of action.
10. Understand the legal rules governing reporting requirements and commitment practices.
11. Utilize peer consultation to inform clinical work and ethical practice.
12. Provide constructive peer consultation.

D. Instructional Strategy
This course format involves student initiated questions and problem solving, facilitated peer consultation, lecture, discussion, reading and presentations to promote the development of ethical, professional practice with clients. Some DVD/video presentations may be used to illustrate problems and solutions regarding ethical/legal concerns, and to serve as focal points for discussion and lecture.

E. Description of Course Requirements and Assessment Methods
Course Requirements:
1. Consistent, on-time attendance is required. If you are unable to attend class, please leave me a voice-mail message as soon as possible (925-284-4777). Students who are consistently late for class or returning from break, or who miss more than 2 classes, risk receiving NO CREDIT for the semester.
2. Class participation, both verbal and non-verbal, is a vital component of this class. In addition to asking questions regarding material presented and required readings, it is expected that students contribute their own ideas, suggestions, and formulations. Students are also expected to demonstrate involvement in class discussions in non-verbal ways (attentive listening, etc.). Checking e-mail, text messaging, doing work for other classes, etc., demonstrates a lack of involvement in the class and is, in addition, considered unprofessional behavior.
3. Oral and written presentations from all students are required and include the following:
a. Oral and written case report (case presentations) on a current clinical case using standard format provided by instructor (first and
second semester).
b. Oral report on a specific ethical or legal topic (second semester only).
4. Demonstration of professional behavior, which includes following the Ethical Principles for psychologists and code of conduct; adhering to school guidelines as listed in the Student Handbook, the Professional Training Manual; and complying with other directives from the administration. In addition, professional behavior includes respectful and responsible speech and actions, completing assignments in a timely way, communicating directly should issues or problems arise, and maintaining professional boundaries, such as the confidentiality of clients and classmates.

Evaluation of Student Learning/Assessment Methods:
Students will be evaluated on a letter grade basis using the criteria listed in course requirements and elaborated below:
1. Attendance (15%) – punctual, consistent
2. Class Participation (15%)
3. Oral and Written Case Report (50%)
Oral Case Report (25%):
*Follows organizational format and structure
*Provides clear sense of client and client-therapist interactions
*Shows evidence of self-reflection (e.g., recognizes impact of client behaviors and interactions on therapist).
*Receives feedback from colleagues in an appropriate, non-defensive manner.
*Utilizes time constraints well
Written Case Report (25%)
*Clear and organized
*Utilizes format
*Graduate level writing – no typos, grammatical errors; professional language. If student has difficulty writing, obtain assistance from tutorial center.
*Identifies relevant treatment/relationship themes and issues
*Incorporates feedback from instructor and colleagues
4. Professional Behavior (20%) – See above
III. Course Readings and Materials:

Required Readings:

California Board of Psychology. (2006). California laws and regulations relating to the practice of psychology. Sacramento, CA: California Department of Consumer Affairs. (can be found at and
downloaded from: http://www.psychboard.ca.gov/laws_regs/laws_regs.pdf)

Compendium of California Law: 2006 (Compiled by Dr. Taube: to be e-mailed)

Fisher, C. (2003). Decoding the Ethics Code: A Practical Guide for Psychologists. NY: Sage Publications.

Koocher, G. & Keith-Spiegel, P. (2007). Ethics in psychology and the mental health professions. New York: Oxford University Press.

Teyber, E. (2005) Interpersonal Process in Psychotherapy: An integrative Model (5th ed.). Thomson: Brooks/Cole

Handouts: (to be e-mailed or made available on line)

Reserve readings: (available in the library at the reserve desk or online)


Recommended Readings: (on reserve or made available in other formats)

These include recommended reading to further broaden and deepen student’s exposure to specific topics. I also recommend that class members read the following periodicals regularly (some are available on line in full text format, and all are available in the library or by subscription):

American Psychologist (full text available online)

APA Monitor

Bennett, B. E., Bryant, B. K., VandenBos, G. R. Greenwood, A. (1990). Professional liability and risk management. Washington, DC: APA.

California Psychologist (a publication of CPA)

Berzoff, J., Flanagan, I.M. & Hertz, P. (1996). Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts. Northvale, New Jersey: Jason Aronson, Inc.

Eells, T., (1997). Handbook of psychotherapy case formulation. New York: Guilford Press.

Perez Foster, R., Mosokovitz, M., & Javier, R. (1996). Reaching across boundaries of culture and class: Widening the scope of psychotherapy. New Jersey: Jason Aronson Inc.

Rave, E., & Larsen, C. (1995). Ethical decision making in therapy: Feminist perspectives. New York: Guilford Press.

Stamm, B.H., (Ed.) (1995). Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. The Sidran Press.

Yalom, I. (2003). The gift of therapy: An open letter to a new generation of therapists and their patients. New York: HarperCollins Publishers, Inc.

Professional Psychology: Research and Practice (full text available on online)


IV. Policies and Procedures:

Behavioral Expectations/Attendance

1. Policies Related To Class Attendance, Lateness, Missed Exams or Assignments
The University expects regular class attendance by all students. Each student is responsible for all academic work missed during absences. When an absence is necessary, students should contact the instructor as soon as possible (925-284-4777) as referred to previously. See the University Catalog for the complete policy on attendance.

Missed assignments or work handed in late will result in a lower grade or failure of the class, depending on the work missed. Missing more than one assignment can result in failing this class, at the discretion of the instructor. If you will be unable to present your case presentation on the day you signed up for, it is your responsibility to contact the instructor and to switch with another student as soon as possible.

2. Information on types of participation required by the course: Regular focus, attention and participation in class are expected. However, cultural differences in
participation levels are understood. Evidence of engagement in class will be recognized both verbal and nonverbal behavior.
3. Instructor Assumptions

First and foremost, it is essential that an atmosphere of mutual respect and support is maintained throughout the year. Professional development is a developmental process involving different struggles for students at different levels of understanding. We will strive to develop a non-judgmental attitude in class in order to facilitate personal, and intellectual development as well as clinical skills.

Although the course material will overlap in both semesters, the first semester will focus more on clinical issues in order to coincide with the beginning of practicum work. The second semester will be weighted more heavily on ethical/legal issues to prepare students for the Ethics, Laws, and Professional Issues of the Preliminary Examinations.

4. Responsibility to Keep Copies
Remember – it is good practice to keep copies of ALL major assignments/papers you turn in. On rare occasions, work may be lost because of computer failure or other unexpected contingencies.
5. Respectful Speech and Actions
Alliant International University, by mission and practice, is committed to fair and respectful consideration of all members of our community, and the greater communities surrounding us. All members of the University must treat each other as they would wish to be treated themselves, with dignity and concern.

As an institution of higher education, Alliant International University has the obligation to combat racism, sexism, and other forms of bias and to provide an equal educational opportunity. Professional codes of ethics (e.g., from the APA for psychology students) and the Academic Code shall be the guiding principles in dealing with speech or actions that, when considered objectively, are abusive and insulting.

6. Academic Code of Conduct and Ethics
The University is committed to principles of scholastic honesty. Its members are expected to abide by ethical standards both in their conduct and in their exercise of responsibility towards other members of the community. Each student’s conduct is expected to be in accordance with the standards of the University. The complete Academic Code, which covers acts of misconduct including assistance during examination, fabrication of data, plagiarism, unauthorized collaboration, and assisting other students in acts of misconduct, among others, may be found in the University Catalog. The University reserves the right to use plagiarism detection software.

Due to the fact that actual clinical material will be presented and discussed in this course, confidentiality must be maintained throughout the year. To preserve client confidentiality, you should not use your client's actual name in your presentations. In addition, no names of the agency in which the client is seen should appear on any written reports. In the unlikely circumstance that you personally know a client being presented, it is your responsibility to excuse yourself from class during that presentation.

Confidentiality of classmates should also be maintained. Countertransference feelings and other personal issues discussed in relation to course material and case presentations are expected to emerge as part of the clinical experience. These discussions should not be shared outside of the classroom.

7. Disability Accommodations Request
If you need disability-related accommodations in this class, please see me privately. All accommodations must be requested in a timely manner (at least 2 weeks ahead of time) with a letter of support for Alliant’s Office of Disability Services. If you have questions about accommodations, please contact the Office of Disability Services (Dr. Nina Ghiselli; nghiselli@alliant.edu).


8. Policy on Course Requirements During Religious Holidays
Alliant International University does not officially observe any religious holidays. However, in keeping with the institution’s commitment to issues of cultural diversity as well as humanitarian considerations, faculty are encouraged to appreciate students’ religious observances by not penalizing them when they are absent from classes on holy days. Alliant International University faculty will be sensitive to these matters. Students should be similarly respectful of faculty members’ right to observe religious days.

9. Resources for Obtaining Tutoring or Other Student Support Services
Tutors are available to help students with course-based or exam-based needs. Contact the Director of Student Support Services for information on obtaining tutoring – or other student support services – on the San Francisco campus.

10. Problem Solving Resources
If problems arise with faculty, other students, staff, or student support services, students should use the University Problem Solving Procedures located on the web at http://www.alliant.edu/academic/studentproblemsolving/Student_Grievance_Policy.pdf or contact the University Ombudsperson at rkunard@alliant.edu.














V. Course Schedule:
The following is the general structure and content of the course. Students should remember that the exact content and schedule of the syllabus is subject to change in order to meet student, faculty, or other needs. We may, for example, spend more time on some topics as needed, and conversely, may move more quickly over other topics.

Fall 2008 Schedule

WEEK 1 9/4/09 Introductions; Orientation to the Course, Student Presentation Assignments, Beginning Practicum, Presenting Clinical Cases.

WEEK 2 9/11/09 Ethical Issues in Beginning Treatment, Parameters of
Treatment
READINGS:
1. Bersoff - Chapter 1. (skip 46-74)
2. Fisher – pp. 247-263
CASE PRESENTATION

WEEK 3 9/18/09 Crisis Intervention, Assessing Suicidality, Danger to Others, Tarasoff, Hospitalization of Clients, 5150, Lanterman-Petris Short Act, Child and Elder Abuse Reporting
READINGS:
1. Bersoff - Chapter 4.
CASE PRESENTATION

WEEK 4 9/25/09 Case Conceptualization/Formulation – Implications for Intervention
READINGS:
1. Teyber - Chapter 1.
CASE PRESENTATION

WEEK 5 10/2/09 Therapeutic Relationship, Therapeutic Alliance
1. Teyber - Chapter 2.
CASE PRESENTATION

WEEK 6 10/9/09 Resistance
READINGS:
1. Teyber - Chapter 3.
CASE PRESENTATION

WEEK 7 10/16/09 Internal Conflict
READINGS:
1. Teyber - Chapter 4.
CASE PRESENTATION

WEEK 8 10/23/09 The Role of Affect
READINGS:
1. Teyber - Chapter 5.
CASE PRESENTATION

WEEK 9 10/30/09 Family therapy.
READINGS:
1. Teyber – Chapter 6
RECOMMENDED READINGS: (on reserve)
1. Minuchin & Fishman - Family Therapy Techniques.
CASE PRESENTATION

WEEK 10 11/6/09 Child Therapy, Working with Parents
READINGS: (on reserve)
1. Cooper, S., and Wanerman, L., "Special Aspects of treatment of children". (p. 65-83). On Reserve.
2. TBA
CASE PRESENTATION

WEEK 11 11/13/09 Case Formulation
READINGS:
1. Teyber – Chapter 7
CASE PRESENTATION

WEEK 12 11/20/09 Interpersonal Themes and Reenactments
READINGS:
1. Teyber – Chapter 8
CASE PRESENTATION

*11/27/09 THANKSGIVING HOLIDAY – NO CLASS

WEEK 13 12/4/09 Transference and Countertransference
READINGS:
1. Teyber – Chapter 9.
2. Perez Foster, et al., Chapter 8 (e-reserve)

WEEK 14 12/11/09 Termination in Psychotherapy. Review of Semester,
Unfinished Business, Course Evaluations
READINGS:
1. Teyber - Chapter 10.
CASE PRESENTATION

[WEEK 15 12/18/09 If Needed – Make-up class]


Spring Schedule

WEEK 1 Orientation to Spring Semester, Student Presentation Assignments, Presenting Clinical Cases.

WEEK 2 Ethical Principles for Psychologists, Ethical Decision Making.
READING:
Fisher - Chapter 1, 2 & 3
CASE PRESENTATION _
ETHICS PRESENTATION
_

WEEK 3 Resolving Ethical Issues.
READING:
Fisher - Chapter 4
Bersoff – Chapter 2 (skip 99-122)
CASE PRESENTATION
_
ETHICS PRESENTATION _

WEEK 4 Ethical Issues Regarding Competence.
READING:
Fisher - Chapter 5
Bersoff – Chapter 3 (skip 126-128, 132-134, 148-153)
CASE PRESENTATION _
ETHICS PRESENTATION
_

HOLIDAY

WEEK 6 Human Relations.
READING:
Fisher - Chapter 6
Bersoff – Chapter 5
CASE PRESENTATION
_
ETHICS PRESENTATION _

WEEK 7 Privacy and Confidentiality.
READING:
Fisher - Chapter 7
CASE PRESENTATION _
ETHICS PRESENTATION
_

WEEK 8 Advertising and Other Public Statements
READING:
Fisher - Chapter 8
CASE PRESENTATION
_
ETHICS PRESENTATION _

WEEK 9 Record Keeping and Fees
READING:
Fisher – Chapter 9
Bersoff – Chapter 10 (skip 535-560)
CASE PRESENTATION _
ETHICS PRESENTATION
_

SPRING BREAK

WEEK 10 Ethics in Education and Training.
READING:
Fisher – Chapter 10
CASE PRESENTATION

ETHICS PRESENTATION _

WEEK 11 Research and Publication.
READING:
Fisher – Chapter 11
Bersoff – Chapter 8 (skip 390-402, 408-435)
CASE PRESENTATION _
ETHICS PRESENTATION
_

WEEK 12 Ethical Issues in Psychological Assessment.
READING:
Fisher – Chapter 12
Bersoff – Chapter 6 (skip 276-282, 293-314)
CASE PRESENTATION
_
ETHICS PRESENTATION _

WEEK 13 Ethical Issues in Therapy.
READING:
Fisher – Chapter 13
Bersoff – Chapter 7
CASE PRESENTATION _
ETHICS PRESENTATION
_


WEEK 14 Ethical Decision Making.
READING:
Fisher – Chapter 14
CASE PRESENTATION
_
ETHICS PRESENTATION _

WEEK 15 Ethical Issues in Forensic Settings, CA Board of Psychology Laws and Regs, Review of Semester, Course Evaluations, Prelim Review
READING:
Bersoff – Chapter 9
CASE PRESENTATION ___